Provider Demographics
NPI:1376152264
Name:KEYUR SHODHAN DDS INC
Entity Type:Organization
Organization Name:KEYUR SHODHAN DDS INC
Other - Org Name:SHODHAN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEYUR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHODHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-251-2666
Mailing Address - Street 1:11213 PALM DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240
Mailing Address - Country:US
Mailing Address - Phone:760-251-2666
Mailing Address - Fax:760-251-7655
Practice Address - Street 1:11213 PALM DR
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240
Practice Address - Country:US
Practice Address - Phone:760-251-2666
Practice Address - Fax:760-251-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental